The purpose of this experimental study was to determine if the availability of a telehealth Internet-based nurse support intervention had an effect on psychological and physiological outcomes, support, satisfaction, usage and communication in persons with cardiovascular disease who use the Internet. The Theory of Online Social Support (LaCoursiere, 2001) was used as the theoretical framework.
A Pretest-Posttest Comparative Control Group Repeated Measures design was employed using 159 persons with cardiovascular disease who were current Internet users. Participants were recruited via the Internet and randomly assigned to one of two groups for six weeks: (1) The Nurse Support group, which included access to the intervention, Internet-based nurse support delivered at a distance, in a web-based group forum; (2) The Self-Care group, which included access to web links only. Data were collected pre-intervention, and 6- and 12-weeks post-intervention.
A univariate analysis of variance (ANOVA) for the intervention period revealed a significant increase in site usage (p < .05) by the Nurse Support group compared to the Self-Care group. Multivariate analyses of variance (MANOVAs) were employed to assess differences in psychological, physiological, and support outcomes. There were no overall significant differences between the pretest and the end of 6 weeks, however between 6 weeks and 12 weeks there was a significant main effect for time (p < .05). Univariate ANOVAs indicated a significant increase in psychological outcomes (p < .05) for both time periods, and a significant interaction for physiological outcomes (p < .05) in the second tune period, with scores increasing in the Nurse Support group, and decreasing in the Self-Care group. At both time periods, there was significantly more satisfaction (p < .05) in the Nurse Support group.
Qualitative analyses of satisfaction at both time periods revealed a combination of eight themes between groups. Analysis of discussion forum communications revealed 98 topics with 685 messages, which were coded and classified by type. A taxonomy of nursing interventions was subsequently developed. The results of this study indicate that Internet based nursing intervention can significantly affect outcomes, and will help to establish nursing role guidelines for medical, informatics and consumer telehealth services.
